Snoring is common – most people snore occasionally – but is not a welcomed physical phenomenon. Snoring is noisy, disturbing, can affect the quality of your sleep and prevents your bedroom partner from having a peaceful night! So what are the causes and treatments of snoring? Technically speaking, snoring is defined as the vibration of respiratory structures and the resulting sound, due to obstructed air movement during breathing while sleeping. In some cases the sound may be soft, but in most cases, rather unpleasant.
Generally speaking, the structures involved during vibration (creating subsequent noise) are the uvula and soft palate; the irregular airflow can be caused by any part of airway. Blockage of these passages can be due to inflamed, enlarged glands or ‘floppy’ soft tissues, a large or set back tongue, a small or receded lower jaw or an obstruction of the nasal passageway. These physical attributes can be hereditary or from environmental influences like smoking, alcohol, medications, allergy, asthma and upper respiratory infection.
Snoring can also be a symptom of sleep apnea, an unhealthy condition. While snoring is caused by a narrow airway, sleep apnea is a true breathing obstruction, which awakens the sleeper to begin breathing again. It can occur frequently and can lead to sleep deprivation with further health repercussions. Snoring is a common symptom of sleep apnea, but snoring by itself does not involve the cessation of breathing.
Besides diagnosing what causes snoring, non-invasive and self-regulatory approaches to control snoring can be a good start: losing weight (decreasing fatty tissues which restrict the airway), sleeping with one’s head elevated and sleeping on one’s side (preventing the gravitational collapse of the airway), limiting alcohol consumption, smoking and medication intake (to prevent dilated, dehydrated, inflamed or floppy tissues), and clearing of the nasal passage (a stuffy nose can make inhalation difficult, creating a vacuum in your throat drawing movements the soft tissues). Nasal decongestants or nasal strips can also be effective in opening up the nasal passage; when combined with a snore guard under a health professional’s care, this can be very effective in treating mild to moderate snoring.
There are several designs of snore guards to aid in suppressing snoring, from a simple diagnostic bite plate to a fixed or adjustable double jaw device which repositions your lower jaw and/or tongue forward and downward (opening the airway at your throat). Ask your dentist whether he or she can help you with fitting a snore guard.If you suffer from severe snoring combined with sleep apnea, a continuous positive airway pressure (CPAP) machine is often used.
In most severe cases, a surgical approach might be advised. Surgical treatments like UPPP (Uvulopalatopharyngoplaty) and TAP (Thermal Ablation Palatoplasty) can relieve physical blockages to the breathing pathway. A pillar procedure (palatal implantation) can stiffen and cease vibration of the soft palate to stop snoring.
Playing the didgeridoo may help snorers!
One solution that might surprise you? Sing and playing musical instruments that tone up your throat muscle and soft tissues of one’s airway can help. Even playing the didgeridoo may help snorers! A 2005 study in the British Medical Journal found that learning and practicing the didgeridoo helped reduce snoring and sleep apnea (!) as well as daytime sleepiness. This appears to work by strengthening throat muscles , thus reducing their tendency to collapse during sleep.
At last, I wish everyone a quiet, peaceful and healthy night’s sleep every night – be well rested and ready to carry on a productive and happy tomorrow!
Do you suffer from Sleep apnea? Do you snore at night? Sleep apnea, a sleep disorder characterized by pauses in breathing during sleep, lasts long enough so that one or more breaths are missed, and such episodes occur repeatedly throughout sleep. Common signs and symptoms include gasping, choking or silences during sleep, sudden awakening during sleep, loud snoring and daytime sleepiness. Not only can sleep apnea affect your energy levels throughout your day, but chronic sleep apnea carries potentially dangerous health affects. Thankfully, your dental professional can help!
Sleep apnea (a lack of oxygen) carries heightened risk of cardiovascular disease, stroke, high blood pressure, arrhythmias, diabetes, and sleep deprived driving accidents. Stroke is associated with obstructive sleep apnea as well, as sufferers have a 30% higher risk of heart attack or premature death than those unaffected. Risk factors can often be managed easily without major medical intervention. Being overweight or obese, nasal congestion or blockage and relaxed tongue/throat muscles often contribute to sleep apnea. Avoiding intake relaxants like alcohol or sedatives can play an important role in reducing the occurrence of sleep apnea.
There are three basic types of sleep apnea. Obstructive Sleep Apnea (OSA) is the only type of sleep apnea that can be treated by your dentist. Central Sleep Apnea is when a person’s brain “forgets” to signal the chest muscles to breathe during sleep. This variation of sleep apnea requires medication prescribed by your physician. Mixed Sleep Apnea is a combination of the preceding two types, and is the most difficult type of sleep apnea to diagnose and treat.
What can be done about sleep apnea – and how can your dentist play a role? The first step is diagnosis. Sleep apnea is diagnosed with a “sleep study”. An individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening, and is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body. Symptoms may be present for years without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance.
One of Many Snore Guard Designs Pictured Above
Once a breathing problem during sleep has been established, there are two main routes of therapy for mild or moderate sleep apnea. The first is Oral Appliance Therapy, to reposition your lower jaw into a forward and downward position, opening up your throat, typically given by your dental care professional or physician. There are several designs from a simple diagnostic one to more sophisticate double jaw design. Your treating health professional will help to determine which would fit you better.
For more severe cases, the use of a continuous positive airway pressure (CPAP) device can help, which ’splints’ the patient’s airway open during sleep by means of forcing pressurized air into the throat. The CPAP machine assists only inhaling, whereas a BiPAP machine assists with both inhaling and exhaling and is used in more severe cases. Home remedies to treat sleep apnea include loose weight, treating allergy to decrease the volume of inflamed soft tissue of the airway, using a humidifier (in conjunction with the CPAP machine), trying a saline nasal spray before sleep.
If you have been diagnosed with OSA and think your dentist can help, be sure to bring your concerns to his or her attention.
Wow – 2009 really flew by! As this year draws to a close and another prepares to bloom, take time to reflect on your life and plan for a better future. Did you do well taking care of yourself this year? Could you do better? What is your new year’s resolution? Being happy with our dental health should be one of our top priorities for 2010. It’s up to us to control our future! Have fun and be safe this new year!
Holidays are a joyful time for friends and family, filled with good food and great memories. During this happy time you must remember to take care of your oral health, not only during the feast but beforehand as well! Since most dental offices close for the winter holidays (some for up to two weeks!), it is a good idea to get a checkup before the holiday – especially if you have any pain or sensitivity.
With regards to holiday staining of your teeth, as I have previously mentioned in a wine blog, white wine has an acid content that tends to increase the risk of stain or darkening of your teeth, if combined with other habits of drinking tea, or similar dark beverages. Do not be fooled by the crystal clear appearance of a white wine – they are certainly capable of dulling your teeth. Both whites and reds are equally capable of staining teeth. Certain acidic properties present in wine (white, red or rose) create micro-porosity etching which rough the surface of your teeth, making your teeth much more susceptible to stains from other foods.
If you were to drink a glass of white wine with a red meat sauce, the acidic properties in the white wine could make your teeth more prone to staining from the red sauce in your meal, or the cup of tea after the dinner! Red wine is still more “dangerous” to the pearly opalescence of your teeth than white, however, as it contains pigment molecules known as chromagen, which will stain your teeth. All wines contain tannins, which act as a binding protein, aiding chromogen to saturate upon the surface of the tooth. Just remember to brush and floss after every meal, especially during the holidays!
When you do drink acidic liquids or eat sugary foods, be sure to rinse your mouth with water. Brush and floss twice daily, and after meals – oral hygiene should be routine to avoid problems. Prevention is the most powerful form of self defense from oral health problems!
Apart from keeping your teeth beautiful and pearly-white, remember not to over-do the quantity of the foods you eat during over the holidays. Lean proteins (like turkey and chicken), veggies (like green beans and yams), fruits (like pumpkin and cranberries) are all delicious in moderation – the Christmas ham could be a bit much (taste everything)! Don’t forget the pumpkin or pecan pie for desert! Holiday meals don’t have to be boring and bland to be healthy; sample everything in moderation. Have a happy and safe new year!
Sure, us Humans may only have two sets of natural teeth that are produced over the course of our entire life, but dinosaurs, particularly the Tyrannosaurus Rex, had many. A fascinating fact: the T-Rex actually produced a new set of teeth every year! 60 Minutes recently featured a headline story entitled “B-Rex” which contained information about the teeth of dinosaurs, specifically the T-Rex.
The new teeth in the dino would grow directly beneath the existing teeth, similar to how our permanent teeth develop beneath our baby teeth. Wouldn’t it be nice to have a replacement tooth grow automatically whenever we have a problem?!
Earlier this year, researcher and long-famed paleontologist Jack Horner had uncovered “B. Rex,” a 68-million year old T-Rex that is giving the academic community a lot to think about, both relating to dinosaurs and to the use of tooth material (and other mineral matter) in fossils. Through a special process of acid dissolution of ancient dino bones, organic material – blood vessels – were extracted and found in near-fresh condition!
“[We] dissolved away pieces of an even older dinosaur – a well-preserved 80-million-year-old duckbill – in acid, and again, found what appear to be blood vessels.” With this matter, new creatures could be genetically grown that had fallen extinct millions of years ago – a dino zoo even! What is interesting about dinosaur teeth however is that they illustrate how versatile teeth are in Earth’s many different life forms.
Humans obviously use their teeth for tearing, chewing and start the process of digesting food; speech and aesthetic purposes are also served by our teeth. Although we only have two sets of natural teeth, we can artificially create new teeth with implant dentistry. Other creatures have no teeth, like ducks and geese, which simply use their bill to seek out food and begin the digestion process.
The systematic replacement of old or broken teeth in dinosaurs is what’s driving research that will hopefully, in the future, result in human teeth being grown for human tooth replacement. Imagine being able to have a real, natural and healthy tooth installed in your mouth!
A new tooth is ready to replace the existing T-Rex tooth!
Current technology, like existing biocompatible metals (such as titanium) are used to replace human parts like hip bones. Biocompatible titanium is used for dental implant fixture, replacing a tooth’s root being implanted in the jaw bone. Porcelain restorations are then attached to the artificial titanium root after proper healing of the jaw bone.
It is also important to remember that not all dental implant restorations are made due to improper oral care or an irresponsible lifestyle! More and more people are being born with congenitally missing teeth, which can cause surrounding teeth to become misaligned, a possible evolutionary trend. Early diagnosis always makes the restoration process easier.
Though technology is constantly evolving, and may at one point completely replace the need for artificial dental restorations, it is of the utmost importance to try and take care of what you have! A person’s original, natural teeth are always the healthiest and most desirable option.
Dental CSI – it may sound funny, but it’s a very real science! Teeth are not only for eating, speaking and looking beautiful, but can be used in crime scene investigations with bite marks and extracted DNA. Dental ID, similar to fingerprint ID, is the most common form of dental forensics, a definitive meansof identification of unknown human remains in forensic investigations.It is routinely acceptable as evidence in court. Because of the resistant nature of dental tissues to environmental assaults, such as incineration, immersion, trauma, mutilation and decomposition, teeth represent an excellent source of DNA material as scientific identification!
Dental DNA can be used in anthropology as well! Earlier this month, doctors from the Massachusetts General Hospital threaded a scope up the neck and into the skull of a disembodied, 4,000-year-old mummified skull, in an effort to extract a molar. The tooth DNA was collected from the pulp of a well-preserved tooth and used to solve an “ancient art mystery,” which could identify his or her gender and age from material lying deep within the pulp of the tooth.
My experience with forensic dentistry was sad and shockingly personal – I had to send dental x-ray records to police department officials for identification of a friend killed in a plane crash.
Even criminals are aware of dental identification. Just this past summer, reality show star Ryan Jenkins had been suspected of killing his ex-wife Fiore; the perpetrator removed her teeth and fingers to destroy her forensic ID. What he didn’t realize was that the breast implants in Fiore’s chest carried a serial number that was later used to identify the body, and subsequently issue a warrant for Jenkins’ arrest. He committed suicide.
Dental identifications have always played a key role in natural and manmade disaster situations, in particular the mass casualties normally associated with aviation disasters. In the attacks on the World Trade Canter on September 11, 2001, only an estimated half of the 2,749 victims were identified – through a mixture of DNA, jewelry, and dental records. The deceased individual’s teeth are photographed and charted with impression materials that can be compared to the dentist’s patient chart, to make a positive identification.
Forensic dentistry has also been used to identify several infamous figures from the Nazi era, including Adolf Hitler, Martin Bormann, Eva Braun, and Joseph Mengele. The assassin responsible for the murder of John F. Kennedy, Lee Harvey Oswald, was also confirmed through dental records. Even the remains of Czar Nicholas II and his family, who were shot during the 1917 Russian Revolution, were initially identified through dental identification.
Forensic evidence in dentistry is a widely-applicable science in the identification of those individuals who cannot be identified visually or by other means or used as evidence utilized in law enforcement, but in scientific discovery as well! Teeth speak the truth!
On Halloween (October 31st) weekend, Autism Awareness Walks took place from San Francisco to New York and everywhere in between. Michelle Parris, a walker in Washington, D.C. came out to the Washington Mall ready to walk 2.5 miles for her son Miles. “I just want other people to not have to deal with the same difficulties that my son has dealt with,” she said. “If there’s a way that we can end it that would be great.” The annual Autism Awareness Walk is to raise funds and awareness to help fight autism, a disorder of neural development that hampers certain skills associated with social interaction and communication. Idiosyncratic use of language is also consistent. People suffering from autism also often suffer from restricted and repetitive behavior. The condition begins to show itself in children as young as two years old. Because much of the condition is still fairly mysterious, raising awareness and funds to fight autism is vital.
Often times, children suffering from autism are very difficult to treat by a physician – especially in dentistry. Autistic children often have a very hard time trusting physicians (especially if he or she is unfamiliar with said physician). In regards to dentistry, autistic children can have difficulty sitting still. This can make orthodontic treatment very difficult, especially if the child does not like braces or feels they are causing him or her pain. An autistic child can be treated just as successfully as any child if he or she is treated with patience and care.
Regarding dental home care, brushing and flossing will require a family member’s daily help and guidance. Nutritional needs for Autistic children are extremely important, not just for dental hygiene, but for the brain. There are researches showing how certain foods seem to affect the developing brain of certain children, causing autistic behavior. This is not because of allergies, but because many of these children are unable to properly break down certain proteins. Researchers in England, Norway, and at the University of Florida had previously found peptides (a breakdown product of proteins) with opiate activity in the urine of a high percentage of autistic children. Opiates are drugs, like morphine, which affect brain function. These findings have recently been confirmed by researchers at Johnson & Johnson’s Ortho Clinical Diagnostics. Gluten-free diets (a protein fraction found in wheat, rye, barley and most oat products) and Casein-free diets (a protein in dairy) are suggested. A professional nutrition consultation is really a must.
I was luckily blessed to have the opportunity to treat some special people who needed special care. Of course, every patient is special in my dictionary, but when dealing with someone who cannot communicate (or resists treatment), the challenge is greater to make that person better. You can also feel the love in between the family members – the special person actually plays the “glue” role to get the family together! When you see them together, it is such a beautiful scene.
Treating Autistic or any other special people can be an extremely rewarding experience. Everything is possible if we determine how to make things better; with patience, love and knowledge, we can experience miracles!
In a story that spread across the news (and the web) in a matter of hours, a revolutionary surgical procedure took place in Florida that essentially used a female patient’s own eye tooth (canine) as a base to hold a prosthetic lens inside her eye, which was blinded nine years ago due to Stevens-Johnson Syndrome. Blind for nine years, Sharron “Kay” Thornton recently regained her vision through a first-in-the-U.S. surgical procedure at Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine. The surgical procedure — modified osteo-odonto-keratoprosthesis (MOOKP) — implanted her canine eyetooth in her eye, as a tissue base to hold a prosthetic lens in place.
The disease, which claimed Sharron Thorton’s vision for so many years is an idiopathic condition (read: spontaneous and of unknown-origin) which causes the epidermis to separate from the dermis in what is often a life-threatening battle. The condition destroys the cells on the surface of the eye causing severe scarring of the cornea. Because the eye is such a sensitive part of the body – which rejects foreign material, including plastics and other man-made objects – a piece of hard natural tissue was needed for the implantation of the prosthetic lens. Because the body would normally reject an artificial base, the eye tooth was chosen as a hard, durable tissue which was composed of natural minerals that the body would not reject.
Corneal specialist Dr. Victor Perez said of the procedure, which was developed in Italy, “MOOKP has proven effective as a solution to end-stage corneal disease where severe corneal scarring blocks vision and corneal transplants are no longer an option but the eye’s internal structures and optic nerve remain healthy. For certain patients whose bodies reject a transplanted or artificial cornea, this procedure ‘of last resort’ implants the patient’s tooth in the eye to anchor a prosthetic lens and restore vision,” he explained.
Before the eye-opening procedure, the eyetooth was actually implanted in the patient’s stomach for several months, in order to expose the tooth to other bodily tissues (blood, plasma etc), preparing the tooth for implantation within the eye. Had the tooth not been cocooned by the body before implantation, the chances of bodily rejection would have been rather high. Medical technologies like these (and revolutionary medical procedures) have helped improve our life so much – dental or other bodily implants have been used routinely with great success, but the bottom line is that prevention still is the best answer for our health and quality of life. When tragedy strikes – as it did with Kay Thorton – a combination of science and fortune just might save the day.
How could this be happening? Medication that is supposed to help and make a patient feeling better produces a deadly reaction?
Simple outpatient surgical procedures – which are performed in clinics, doctor offices and dental practices on a daily basis – which require mild to moderate painkillers is customary and routine may turn out to be fatal. The case in question occurred last weekend when an otherwise healthy 2-year-old boy died after being prescribed codeine to relieve pain from having his tonsils removed. The sad fact is that cases like this even the protocol of post operative was followed, and very little could have been done to avoid such a tragedy.
The child mentioned above had a history of snoring and sleep apnea (when a person momentarily stops breathing during sleep throughout the night). In an effort to clear the boy’s airway, he had a routine tonsillectomy outpatient surgery and was sent home. Doctors prescribed codeine syrup and told the boy’s mother to give it to him for pain, but two nights later, the child developed a fever and wheezing. He was found dead the next morning, according to the report.
Although the coroner’s office noted that toxicology tests showed the mother had given the child the proper dosage, the boy had high levels of morphine in his system, which is metabolized from codeine. Further investigation determined that the child had an ultra-rapid metabolism genotype, which causes the body to metabolize codeine at a faster rate than the norm. The only true way to have avoided this tragedy would have been to keep the child in the hospital overnight, for 24 hours, for observation to see whether his breathing had improved, and whether pain medications (such as codeine, which suppresses the respiratory system) could have put him at risk.
The take home message here is that common, routine dental procedures which involve pain relievers (like wisdom tooth extraction or implant surgery) must always be treated with the utmost care and attention.Be aware the potential risk of toxicity and allergic reaction of any medication . If you are unsure of your body’s reaction to certain medications or pain relievers, consult with your dental professional or primary care physician. If you have a child who is about to undergo an outpatient procedure, speak with his or her physician before the procedure. Are there any potential risks associated with the procedure, or with the post -operative medications ? Know your child and know their body – proper supervision is essential, especially with children.
Redheads feel more pain! New research published in the July 09 Journal of The American Dental Association found that painful experiences at the dentist might cause more anxiety for men and women with red hair, who were twice as likely to avoid dental care than people with dark hair. Red-headed children or adults might avoid dental visits and might be at a higher risk of affecting their dental health!
A child that has an unfounded fear of the dentist (or even a founded one, instilled by parents who aren’t very fond of their dentist or past experiences in the dental chair) are common, however due to a scientific quirk (thanks to mother nature), redheaded individuals do feel pain more intensely than non-red-headed persons. These extra sensitivities to pain might lead to negative experiences with dental visits, which as being parental health care providers, we should be aware of these phenomena.
There are two studies that exist. In 2004, research showed that people withred hair need twenty percent more general anesthesia than blonds or brunettes. A 2005 study indicated that redheads are more sensitive to thermal pain and are more resistant to the effects of local anesthesia. Researchers believe variants of the melanocortin-1 receptor gene play a role. This MC1R gene produces melanin, which gives skin, hair and eyes their color.
While blond, brown and black-haired people produce melanin, those with red hair have a mutation of this receptor. It produces a different coloring called pheomelanin, which results in freckles, fair skin and ginger hair. About 5 percent of whites are estimated to have these characteristics. The relationship between MC1R and pain sensitivity is still under study, researchers have found MC1R receptors in the brain and some of them are known to influence pain sensitivity. Non-redheads can also carry a variant of the MC1R gene. In this dental study that had 144 participants, about a quarter of the non-redheads had variants of the MC1R gene. These people also experienced heightened anxiety and avoided dental care compared with others who did not have the variant. There is no commercial test available for variations of the MC1R gene.
The best tips for redheads are to work on the prevention of dental problems, inform your health provider that you are highly sensitive, use TLC and be patient, wait a bit longer to let the anesthesia start to work and finally inform your doctor that you might require additional amounts of local anesthesia – because you are a special redhead!
As we’ve learned time in and time out, the oral cavity is integrally and systematically linked to the health of various other bodily systems – here we are focusing on kidneys. The kidneys serve for the production of urine as their primary function, excreting unnecessary bodily fluids and compounds. Kidneys also have several secondary functions concerned with homeostatic functions. These include the regulation of electrolytes, acid-base balance, and blood pressure. If you have kidney problems, apart from the well-advertised urinary and homeostatic problems, your oral health could deteriorate as well!
People with long-lasting (or even recently discovered) kidney problems often times have a bad taste in their mouths. Also related, they often have bad breath (halitosis). These problems – both of which are indicators of a serious problem in your system – occur because the kidneys fail to remove the organic compound urea from the blood. Urea breaks down to form ammonia, which has a pungent odor that is quickly noticeable; bone changes may also occur because the body cannot absorb calcium properly. Imbalanced calcium levels will weaken your bones, loosing bone from your jaw. Teeth may become loose or eventually fall out because of the calcium deficiency often resulting from kidney disease. The best way to help prevent bone loss is to make sure calcium and phosphorus levels stay within the goal range.
Anorexia, anemia, xerostomia, high blood pressure and heart disease, inflammation of the mouth, salivary glands and gum disease can all be symptoms and complications when dealing with kidney disease, apart from the influence of medication. When you have these symptoms, not only should a dental professional be contacted to provide dental examinations and treatment, but also a physical examination is needed. If you have kidney disease or are on dialysis, you should plan to receive any dental treatments on non-dialysis days for those on hemodialysis. Heperin, administered during hemodialysis, may cause some people to have prolonged bleeding. Kidney disease can also weaken the immune system and make us more susceptible to infection, so prophylactic antibiotics maybe needed before invasive dental treatment.
During the work up for a kidney transplant, a person will need to have a thorough oral examination. Any infection or disease of the gum or tooth can prevent someone from being eligible, or delay the transplant until the patient is free of gum and dental infection .
Keep up your home care program, brush and floss after every meal and follow a properly designed diet by your dietitian. Special dietary needs must be met if you have a compromised kidney condition. Regular visits to the dentist can also reduce the risk of oral infection and dental disease.
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